Nervous System Chapter-Tina Sanders

08Scanlon(p3)-ch08 8/17/06 10:48 AM Page 163
Copyright © 2007 by F. A. Davis.
CHAPTER 8
The Nervous System
163
CHAPTER 8
Chapter Outline Neurotransmitters

Nervous System Divisions Aging and the Nervous System
Nerve Tissue
Synapses BOX 8–1 MULTIPLE MCLEROSIS
Types of Neurons BOX 8–2 SHINGLES
Nerves and Nerve Tracts BOX 8–3 SPINAL CORD INJURIES
The Nerve Impulse BOX 8–4 CEREBROVASCULAR ACCIDENTS
The Spinal Cord BOX 8–5 APHASIA
Spinal Nerves BOX 8–6 ALZHEIMER’S DISEASE
Spinal Cord Reflexes BOX 8–7 PARKINSON’S DISEASE
Reflex arc BOX 8–8 LUMBAR PUNCTURE
The Brain
Ventricles
Medulla Student Objectives
Pons • Name the divisions of the nervous system and the
Midbrain parts of each, and state the general functions of
Cerebellum the nervous system.
Hypothalamus • Name the parts of a neuron and state the function
Thalamus of each.
Cerebrum • Explain the importance of Schwann cells in the
Frontal lobes peripheral nervous system and neuroglia in the
Parietal lobes central nervous system.
Temporal lobes • Describe the electrical nerve impulse, and describe
Occipital lobes impulse transmission at synapses.
Association areas • Describe the types of neurons, nerves, and nerve
Basal ganglia tracts.
Corpus callosum • State the names and numbers of the spinal nerves,
Meninges and Cerebrospinal Fluid and their destinations.
Cranial Nerves • Explain the importance of stretch reflexes and
The Autonomic Nervous System flexor reflexes.
Autonomic Pathways • State the functions of the parts of the brain; be
Sympathetic Division able to locate each part on a diagram.
Parasympathetic Division • Name the meninges and describe their locations.
164
The Nervous System
Student Objectives (Continued) Parasympathetic (PAR-uh-SIM-puh-THET-ik)

Reflex (REE-fleks)
• State the locations and functions of cerebrospinal
fluid. Somatic (soh-MA-tik)
Spinal nerves (SPY-nuhl NERVS)
• Name the cranial nerves, and state their functions.
Sympathetic (SIM-puh-THET-ik)
• Explain how the sympathetic division of the auto-
nomic nervous system enables the body to adapt Ventricles of brain (VEN-trick’ls)
to a stress situation. Visceral (VISS-er-uhl)
White matter (WIGHT MA-TUR)
• Explain how the parasympathetic division of the
autonomic nervous system promotes normal body
functioning in relaxed situations.
Related Clinical Terminology
Alzheimer’s disease (ALZ-high-mer’s)
New Terminology Aphasia (ah-FAY-zee-ah)
Afferent (AFF-uh-rent) Blood–brain barrier (BLUHD BRAYNE)
Autonomic nervous system (AW-toh-NOM-ik) Cerebrovascular accident (CVA) (se-REE-broh-
Cauda equina (KAW-dah ee-KWHY-nah) VAS-kyoo-lur)
Cerebral cortex (se-REE-bruhl KOR-teks) Lumbar puncture (LUM-bar PUNK-chur)
Cerebrospinal fluid (se-REE-broh-SPY-nuhl) Meningitis (MEN-in-JIGH-tis)
Choroid plexus (KOR-oid PLEK-sus) Multiple sclerosis (MS) (MULL-ti-puhl skle-
Corpus callosum (KOR-pus kuh-LOH-sum) ROH-sis)
Cranial nerves (KRAY-nee-uhl NERVS) Neuralgia (new-RAL-jee-ah)
Efferent (EFF-uh-rent) Neuritis (new-RYE-tis)
Gray matter (GRAY MA-TUR) Neuropathy (new-RAH-puh-thee)
Neuroglia (new-ROG-lee-ah) Parkinson’s disease (PAR-kin-son’s)
Neurolemma (NYOO-ro-LEM-ah) Remission (ree-MISH-uhn)
Spinal shock (SPY-nuhl SHAHK)
Terms that appear in bold type in the chapter text are defined in the glossary, which begins on page 547.
165
166 The Nervous System
M ost of us can probably remember being told,

when we were children, not to touch the stove or some
in the trunk of the body. In these locations, cell bodies
are protected by bone. There are no cell bodies in the
other source of potential harm. Because children are arms and legs, which are much more subject to injury.
curious, such warnings often go unheeded. The Dendrites are processes (extensions) that transmit
result? Touching a hot stove brings about an immedi- impulses toward the cell body. The one axon of a neu-
ate response of pulling away and a vivid memory of ron transmits impulses away from the cell body. It is
painful fingers. This simple and familiar experience the cell membrane of the dendrites, cell body, and
illustrates the functions of the nervous system: axon that carries the electrical nerve impulse.
In the peripheral nervous system, axons and den-
1. To detect changes and feel sensations
drites are “wrapped” in specialized cells called
2. To initiate appropriate responses to changes
Schwann cells (see Fig. 8–1). During embryonic
3. To organize information for immediate use and
development, Schwann cells grow to surround the
store it for future use
neuron processes, enclosing them in several layers of
The nervous system is one of the regulating sys- Schwann cell membrane. These layers are the myelin
tems (the endocrine system is the other and is dis- sheath; myelin is a phospholipid that electrically insu-
cussed in Chapter 10). Electrochemical impulses of lates neurons from one another. Without the myelin
the nervous system make it possible to obtain infor- sheath, neurons would short-circuit, just as electrical
mation about the external or internal environment wires would if they were not insulated (see Box 8–1:
and do whatever is necessary to maintain homeostasis. Multiple Sclerosis).
Some of this activity is conscious, but much of it hap- The spaces between adjacent Schwann cells, or seg-
pens without our awareness. ments of the myelin sheath, are called nodes of
Ranvier (neurofibril nodes). These nodes are the parts
of the neuron cell membrane that depolarize when an
NERVOUS SYSTEM DIVISIONS electrical impulse is transmitted (see “The Nerve
Impulse” section, on pages 171–172).
The nervous system has two divisions. The central The nuclei and cytoplasm of the Schwann cells are
nervous system (CNS) consists of the brain and wrapped around the outside of the myelin sheath and
spinal cord. The peripheral nervous system (PNS) are called the neurolemma, which becomes very
consists of cranial nerves and spinal nerves. The PNS important if nerves are damaged. If a peripheral nerve
includes the autonomic nervous system (ANS). is severed and reattached precisely by microsurgery,
The peripheral nervous system relays information the axons and dendrites may regenerate through the
to and from the central nervous system, and the brain tunnels formed by the neurolemmas. The Schwann
is the center of activity that integrates this informa- cells are also believed to produce a chemical growth
tion, initiates responses, and makes us the individuals factor that stimulates regeneration. Although this re-
we are. generation may take months, the nerves may eventu-
ally reestablish their proper connections, and the
person may regain some sensation and movement in
NERVE TISSUE the once-severed limb.
In the central nervous system, the myelin sheaths
Nerve tissue was briefly described in Chapter 4, so we are formed by oligodendrocytes, one of the neu-
will begin by reviewing what you already know and roglia (glial cells), the specialized cells found only in
then add to it. the brain and spinal cord. Because no Schwann cells
Nerve cells are called neurons, or nerve fibers. are present, however, there is no neurolemma, and
Whatever their specific functions, all neurons have the regeneration of neurons does not occur. This is why
same physical parts. The cell body contains the severing of the spinal cord, for example, results in per-
nucleus (Fig. 8–1) and is essential for the continued manent loss of function. Another kind of neuroglia are
life of the neuron. As you will see, neuron cell bodies microglia,which are constantly moving, phagocytiz-
are found in the central nervous system or close to it ing cellular debris, damaged cells, and pathogens.
The Nervous System 167
Afferent (sensory) neuron Efferent (motor) neuron

Dendrites
Axon terminal
Cell body
Axon
Nucleus
Nucleus
Figure 8–1. Neuron struc-
ture. (A) A typical sensory neu-
ron. (B) A typical motor neuron.
The arrows indicate the direc- Axon
tion of impulse transmission. Schwann cell nucleus
(C) Details of the myelin sheath
Myelin sheath
and neurolemma formed by
Schwann cells.
QUESTION: The axon terminal
Node of
of the motor neuron would be Cell body
Ranvier
found at what kinds of effec-
tors?
Schwann cell
Functional dendrite
Myelin sheath Axon
Neurolemma
Layers of myelin sheath
C
Receptors
Axon terminal
A B
Yet another type of glial cell is the astrocyte (liter- more sensitive to even low levels of them than are
ally, “star cell”). In the embryo, these cells provide a other tissues such as muscle tissue or connective tis-
framework for the migrating neurons that will form sue. The capillaries of the brain also contribute to this
the brain. Thereafter, the extensions of astrocytes are barrier, because they are less permeable than are other
wrapped around brain capillaries and contribute to the capillaries. A disadvantage of the blood–brain barrier
blood–brain barrier, which prevents potentially is that some useful medications cannot cross it, and
harmful waste products in the blood from diffusing the antibodies produced by lymphocytes cross only
out into brain tissue. These waste products are normal with difficulty. This becomes an important considera-
in the blood and tissue fluid, but brain tissue is much tion when treating brain infections or other diseases
BOX 8–1 MULTIPLE SCLEROSIS
Multiple sclerosis (MS) is a demyelinating dis- protect the axon. Because loss of myelin may
ease; that is, it involves deterioration of the myelin occur in many parts of the central nervous system,
sheath of neurons in the central nervous system. the symptoms vary, but they usually include muscle
Without the myelin sheath, the impulses of these weakness or paralysis, numbness or partial loss
neurons are short-circuited and do not reach their of sensation, double vision, and loss of spinal
proper destinations, and the neuron axons are cord reflexes, including those for urination and
damaged and gradually die. defecation.
Multiple sclerosis is an autoimmune disorder The first symptoms usually appear between the
that may be triggered by a virus or bacterial infec- ages of 20 and 40 years, and the disease may
tion. Research has also uncovered a genetic com- progress either slowly or rapidly. Some MS patients
ponent to some clusters of MS cases in families. have remissions, periods of time when their symp-
Exactly how such genes would increase a person’s toms diminish, but remissions and progression of
susceptibility to an autoimmune disease is not the disease are not predictable. There is still no cure
yet known. In MS, the autoantibodies destroy for MS, but therapies include suppression of the
the oligodendrocytes, the myelin-producing neu- immune response, and interferon, which seems to
roglia of the central nervous system, which results prolong remissions in some patients. The possibility
in the formation of scleroses, or plaques of scar of stimulating remyelination of neurons is also
tissue, that do not provide electrical insulation or being investigated.
or disorders (Table 8–1 summarizes the functions of naptic axon is a chemical neurotransmitter that is
the neuroglia). released into the synapse by the arrival of an electrical
nerve impulse (Fig. 8–2). The neurotransmitter dif-
SYNAPSES fuses across the synapse, combines with specific recep-
tor sites on the cell membrane of the postsynaptic
Neurons that transmit impulses to other neurons do
neuron, and there generates an electrical impulse that
not actually touch one another. The small gap or space
is, in turn, carried by this neuron’s axon to the next
between the axon of one neuron and the dendrites or
synapse, and so forth. A chemical inactivator at the
cell body of the next neuron is called the synapse.
cell body or dendrite of the postsynaptic neuron
Within the synaptic knob (terminal end) of the presy-
quickly inactivates the neurotransmitter. This pre-
vents unwanted, continuous impulses, unless a new
impulse from the first neuron releases more neuro-
Table 8–1 NEUROGLIA transmitter.
Many synapses are termed excitatory, because the
Name Function
neurotransmitter causes the postsynaptic neuron to
Oligodendrocytes • Produce the myelin sheath to depolarize (become more negative outside as Na⫹ ions
electrically insulate neurons of enter the cell) and transmit an electrical impulse to
the CNS. another neuron, muscle cell, or gland. Some synapses,
Microglia • Capable of movement and however, are inhibitory, meaning that the neurotrans-
phagocytosis of pathogens mitter causes the postsynaptic neuron to hyperpolar-
and damaged tissue.
ize (become even more positive outside as K⫹ ions
Astrocytes • Support neurons, help main- leave the cell or Cl⫺ ions enter the cell) and therefore
tain K⫹ level, contribute to the
blood–brain barrier. not transmit an electrical impulse. Such inhibitory
synapses are important, for example, for slowing the
Ependyma • Line the ventricles of the
brain; many of the cells have heart rate, and for balancing the excitatory impulses
cilia; involved in circulation of transmitted to skeletal muscles. With respect to the
cerebrospinal fluid. skeletal muscles, this inhibition prevents excessive
contraction and is important for coordination.
Vesicles of neurotransmitter Receptor site

Axon of presynaptic
neuron Inactivator
(cholinesterase)
Dendrite of
postsynaptic
neuron
Na+
Na+
Na+
Inactivated
neurotransmitter
Mitochondrion
Neurotransmitter
(acetylcholine)
Figure 8–2. Impulse transmission at a synapse. The arrow indicates the direction of the
electrical impulse.
QUESTION: Is this an excitatory synapse or an inhibitory synapse? Explain your answer.
One important consequence of the presence of esterase is the inactivator of acetylcholine. There are
synapses is that they ensure one-way transmission of many other neurotransmitters, especially in the cen-
impulses in a living person. A nerve impulse cannot go tral nervous system. These include dopamine, GABA,
backward across a synapse because there is no neuro- norepinephrine, glutamate, and serotonin. Each of
transmitter released by the dendrites or cell body. these neurotransmitters has its own chemical inactiva-
Neurotransmitters can be released only by a neuron’s tor. Some neurotransmitters are reabsorbed into the
axon, which does not have receptor sites for it, as does neurons that secreted them; this process is called
the postsynaptic membrane. Keep this in mind when reuptake and also terminates the effect of the trans-
we discuss the types of neurons later in the chapter. mitter.
An example of a neurotransmitter is acetylcholine, The complexity and variety of synapses make them
which is found at neuromuscular junctions, in the frequent targets of medications. For example, drugs
CNS, and in much of the peripheral nervous system. that alter mood or behavior often act on specific neu-
Acetylcholine usually makes a postsynaptic membrane rotransmitters in the brain, and antihypertensive
more permeable to Na⫹ ions, which brings about drugs affect synapse transmission at the smooth mus-
depolarization of the postsynaptic neuron. Cholin- cle of blood vessels.
tion. Sensory neurons from receptors in skin, skeletal

TYPES OF NEURONS muscles, and joints are called somatic; those from
receptors in internal organs are called visceral sensory
Neurons may be classified into three groups: sensory neurons.
neurons, motor neurons, and interneurons (Fig. 8–3). Motor neurons (or efferent neurons) carry
Sensory neurons (or afferent neurons) carry im- impulses from the central nervous system to effectors.
pulses from receptors to the central nervous system. The two types of effectors are muscles and glands. In
Receptors detect external or internal changes and response to impulses, muscles contract or relax and
send the information to the CNS in the form of glands secrete. Motor neurons linked to skeletal mus-
impulses by way of the afferent neurons. The central cle are called somatic; those to smooth muscle, cardiac
nervous system interprets these impulses as a sensa- muscle, and glands are called visceral.
Central canal
Interneuron
Synapse Dorsal column
Dorsal root
Dorsal root ganglion

Corticospinal tract
Rubrospinal tract
Cell body of Spinothalamic tract
sensory neuron
Dendrite of
sensory neuron
White matter
Gray matter
Receptor Ventral root Cell body of motor neuron

Axon of motor neuron
Synaptic knobs
Effector muscle
Figure 8–3. Cross-section of the spinal cord and the three types of neurons. Spinal nerve
roots and their neurons are shown on the left side. Spinal nerve tracts are shown in the
white matter on the right side. All tracts and nerves are bilateral (both sides).
QUESTION: The dorsal column is an ascending tract, and the corticospinal tract is
descending. Explain what this means.
Sensory and motor neurons make up the peripheral mitter) makes the membrane very permeable to Na⫹
nervous system. Visceral motor neurons form the ions, which rush into the cell. This brings about
autonomic nervous system, a specialized subdivision depolarization, a reversal of charges on the mem-
of the PNS that will be discussed later in this chapter. brane. The outside now has a negative charge, and the
Interneurons are found entirely within the central inside has a positive charge.
nervous system. They are arranged so as to carry only As soon as depolarization takes place, the neuron
sensory or motor impulses, or to integrate these func- membrane becomes very permeable to K⫹ ions, which
tions. Some interneurons in the brain are concerned rush out of the cell. This restores the positive charge
with thinking, learning, and memory. outside and the negative charge inside, and is called
A neuron carries impulses in only one direction. repolarization. (The term action potential refers to
This is the result of the neuron’s structure and loca- depolarization followed by repolarization.) Then the
tion, as well as its physical arrangement with other sodium and potassium pumps return Na⫹ ions outside
neurons and the resulting pattern of synapses. The and K⫹ ions inside, and the neuron is ready to respond
functioning nervous system, therefore, is an enormous to another stimulus and transmit another impulse. An
network of “one-way streets,” and there is no danger action potential in response to a stimulus takes place
of impulses running into and canceling one another very rapidly and is measured in milliseconds. An indi-
out. vidual neuron is capable of transmitting hundreds of
action potentials (impulses) each second. A summary
of the events of nerve impulse transmission is given in
NERVES AND NERVE TRACTS Table 8–2.
Transmission of electrical impulses is very rapid.
A nerve is a group of axons and/or dendrites of many The presence of an insulating myelin sheath increases
neurons, with blood vessels and connective tissue. the velocity of impulses, since only the nodes of
Sensory nerves are made only of sensory neurons. Ranvier depolarize. This is called saltatory conduc-
The optic nerves for vision and olfactory nerves for tion. Many of our neurons are capable of transmitting
smell are examples of nerves with a purely sensory impulses at a speed of many meters per second.
function. Motor nerves are made only of motor neu- Imagine a person 6 feet (about 2 meters) tall who stubs
rons; autonomic nerves are motor nerves. A mixed his toe; sensory impulses travel from the toe to the
nerve contains both sensory and motor neurons. Most brain in less than a second (crossing a few synapses
of our peripheral nerves, such as the sciatic nerves in along the way). You can see how the nervous system
the legs, are mixed nerves. can communicate so rapidly with all parts of the body,
The term nerve tract refers to groups of neurons and why it is such an important regulatory system.
within the central nervous system. All the neurons in At synapses, nerve impulse transmission changes
a nerve tract are concerned with either sensory or from electrical to chemical and depends on the release
motor activity. These tracts are often referred to as of neurotransmitters. Although diffusion across
white matter; the myelin sheaths of the neurons give synapses is slow, the synapses are so small that this
them a white color. does not significantly affect the velocity of impulses in
a living person.
THE NERVE IMPULSE

THE SPINAL CORD
The events of an electrical nerve impulse are the same
as those of the electrical impulse generated in muscle The spinal cord transmits impulses to and from the
fibers, which is discussed in Chapter 7. Stated simply, brain and is the integrating center for the spinal cord
a neuron not carrying an impulse is in a state of polar- reflexes. Although this statement of functions is very
ization, with Na⫹ ions more abundant outside the brief and sounds very simple, the spinal cord is of
cell, and K⫹ ions and negative ions more abundant great importance to the nervous system and to the
inside the cell. The neuron has a positive charge on body as a whole.
the outside of the cell membrane and a relative nega- Enclosed within the vertebral canal and the menin-
tive charge inside. A stimulus (such as a neurotrans- ges, the spinal cord is well protected from mechanical
impulses to the brain. Descending tracts (such as the

Table 8–2 THE NERVE IMPULSE
corticospinal and rubrospinal tracts) carry motor
State or Event Description impulses away from the brain. Lastly, find the central
canal; this contains cerebrospinal fluid and is con-
Polarization • Neuron membrane has a (⫹) tinuous with cavities in the brain called ventricles.
(the neuron charge outside and a (⫺) charge
is not carrying inside.
an electrical • Na⫹ ions are more abundant out- SPINAL NERVES
impulse) side the cell.
• K⫹ ions and negative ions are There are 31 pairs of spinal nerves, those that emerge
more abundant inside the cell. from the spinal cord. The nerves are named according
Sodium and potassium pumps to their respective vertebrae: 8 cervical pairs, 12 tho-
maintain these ion concentrations. racic pairs, 5 lumbar pairs, 5 sacral pairs, and 1 very
Depolarization • Neuron membrane becomes very small coccygeal pair. These are shown in Fig. 8–4;
(generated permeable to Na⫹ ions, which notice that each nerve is designated by a letter and a
by a stimulus) rush into the cell. number. The 8th cervical nerve is C8, the 1st thoracic
• The neuron membrane then has a
(⫺) charge outside and a (⫹) nerve is T1, and so on.
charge inside. In general, the cervical nerves supply the back of
Propagation of • Depolarization of part of the the head, neck, shoulders, arms, and diaphragm (the
the impulse membrane makes adjacent mem- phrenic nerves). The first thoracic nerve also con-
from point brane very permeable to Na⫹ ions, tributes to nerves in the arms. The remaining thoracic
of stimulus and subsequent depolarization, nerves supply the trunk of the body. The lumbar and
which similarly affects the next sacral nerves supply the hips, pelvic cavity, and legs.
part of the membrane, and so on.
• The depolarization continues Notice that the lumbar and sacral nerves hang below
along the membrane of the neu- the end of the spinal cord (in order to reach their
ron to the end of the axon. proper openings to exit from the vertebral canal); this
Repolarization • Neuron membrane becomes very is called the cauda equina, literally, the “horse’s tail.”
(immediately permeable to K⫹ ions, which rush Some of the important peripheral nerves and their
follows out of the cell. This restores the destinations are listed in Table 8–3.
depolarization) (⫹) charge outside and (⫺) Each spinal nerve has two roots, which are neurons
charge inside the membrane.
• The Na⫹ ions are returned outside entering or leaving the spinal cord (see Fig. 8–3). The
and the K⫹ ions are returned dorsal root is made of sensory neurons that carry
inside by the sodium and potas- impulses into the spinal cord. The dorsal root gan-
sium pumps. glion is an enlarged part of the dorsal root that con-
• The neuron is now able to tains the cell bodies of the sensory neurons. The term
respond to another stimulus and
generate another impulse. ganglion means a group of cell bodies outside the
CNS. These cell bodies are within the vertebral canal
and are thereby protected from injury (see Box 8–2:
Shingles).
The ventral root is the motor root; it is made of
injury. In length, the spinal cord extends from the
the axons of motor neurons carrying impulses from
foramen magnum of the occipital bone to the disc
the spinal cord to muscles or glands. The cell bodies
between the first and second lumbar vertebrae.
of these motor neurons, as mentioned previously, are
A cross-section of the spinal cord is shown in Fig.
in the gray matter of the spinal cord. When the two
8–3; refer to it as you read the following. The internal
nerve roots merge, the spinal nerve thus formed is a
gray matter is shaped like the letter H; gray matter
mixed nerve.
consists of the cell bodies of motor neurons and
interneurons. The external white matter is made of
SPINAL CORD REFLEXES
myelinated axons and dendrites of interneurons.
These nerve fibers are grouped into nerve tracts based When you hear the term reflex, you may think of an
on their functions. Ascending tracts (such as the dor- action that “just happens,” and in part this is so. A
sal columns and spinothalamic tracts) carry sensory reflex is an involuntary response to a stimulus, that is,
C1
C2 Cervical plexus
C3
Spinal cord C4
C5
Phrenic nerve C6
Brachial plexus
C7
C8
T1
Intercostal nerves
T2
T3
T4
T5
T6
T7
T8
Figure 8–4. The spinal cord T9
and spinal nerves. The distribu- T10
tion of spinal nerves is shown Radial nerve
only on the left side. The nerve T11
plexuses are labeled on the
right side. A nerve plexus is a Median nerve T12
network of neurons from sev- L1
eral segments of the spinal cord Ulnar nerve
that combine to form nerves to L2
specific parts of the body. For Lumbar plexus
example, the radial and ulnar L3
Cauda equina
nerves to the arm emerge from
the brachial plexus (see also L4
Table 8–3).
QUESTION: Where does the L5
Femoral nerve
spinal cord end? Why is this S1
important clinically? Sacral plexus
S2
S3
S4
S5
CO1
Sciatic nerve
173
Table 8–3 MAJOR PERIPHERAL NERVES
Spinal Nerves
Nerve That Contribute Distribution
Phrenic C3–C5 • Diaphragm

Radial C5–C8, T1 • Skin and muscles of posterior arm, forearm, and hand; thumb and first 2 fingers
Median C5–C8, T1 • Skin and muscles of anterior arm, forearm, and hand
Ulnar C8, T1 • Skin and muscles of medial arm, forearm, and hand; little finger and ring finger
Intercostal T2–T12 • Intercostal muscles, abdominal muscles; skin of trunk
Femoral L2–L4 • Skin and muscles of anterior thigh, medial leg, and foot
Sciatic L4–S3 • Skin and muscles of posterior thigh, leg and foot
an automatic action stimulated by a specific change of 1. Receptors—detect a change (the stimulus) and
some kind. Spinal cord reflexes are those that do not generate impulses.
depend directly on the brain, although the brain may 2. Sensory neurons—transmit impulses from recep-
inhibit or enhance them. We do not have to think tors to the CNS.
about these reflexes, which is very important, as you 3. Central nervous system—contains one or more
will see. synapses (interneurons may be part of the pathway).
4. Motor neurons—transmit impulses from the
Reflex Arc CNS to the effector.
5. Effector—performs its characteristic action.
A reflex arc is the pathway that nerve impulses travel
when a reflex is elicited, and there are five essential Let us now look at the reflex arc of a specific reflex,
parts: the patellar (or knee-jerk) reflex, with which you are
BOX 8–2 SHINGLES
Shingles is caused by the same virus that causes cure, some antiviral medications lessen the duration
chickenpox: the herpes varicella-zoster virus. of the illness. A vaccine is being developed for
Varicella is chickenpox, which many of us probably adults. Though it may not completely prevent shin-
had as children (there is now a vaccine). When a gles, it is expected to lessen the chance of posther-
person recovers from chickenpox, the virus may petic neuralgia.
survive in a dormant (inactive) state in the dorsal
root ganglia of some spinal nerves. For most peo-
ple, the immune system is able to prevent reactiva-
tion of the virus. With increasing age, however, the
immune system is not as effective, and the virus
may become active and cause zoster, or shingles.
The virus is present in sensory neurons, often
those of the trunk, but the damage caused by the
virus is seen in the skin over the affected nerve. The
raised, red lesions of shingles are often very painful
and follow the course of the nerve on the skin exter-
nal to it. Pain may continue even after the rash
heals; this is postherpetic neuralgia. Occasionally Box Figure 8–A Lesions of shingles on skin of trunk. (From
the virus may affect a cranial nerve and cause facial Goldsmith, LA, Lazarus, GS, and Tharp, MD: Adult and Pediatric
paralysis called Bell’s palsy (7th cranial) or extensive Dermatology: A Color Guide to Diagnosis and Treatment. FA
facial lesions, or, rarely, blindness. Although not a Davis, Philadelphia, 1997, p 307, with permission.)
(2) Sensory neuron Dorsal root ganglion
Femoral nerve Dorsal root

(5) Quadriceps femoris muscle
(contracts)
(1) Stretch receptor
Stimulus
Figure 8–5. Patellar reflex. The
reflex arc is shown. See text for Biceps
description. femoris
QUESTION: Why is this reflex muscle
called a stretch reflex? (relaxes)
(4) Motor neuron

Gray matter
Ventral root
(3) Synapse in
spinal cord
probably familiar. In this reflex, a tap on the patellar the body perfectly still? No, it isn’t, because gravity
tendon just below the kneecap causes extension of the exerts a downward pull. However, if the body tilts to
lower leg. This is a stretch reflex, which means that a the left, the right sides of the leg and trunk are
muscle that is stretched will automatically contract. stretched, and these stretched muscles automatically
Refer now to Fig. 8–5 as you read the following: contract and pull the body upright again. This is the
In the quadriceps femoris muscle are (1) stretch purpose of stretch reflexes; they help keep us upright
receptors that detect the stretching produced by strik- without our having to think about doing so. If the
ing the patellar tendon. These receptors generate brain had to make a decision every time we swayed a
impulses that are carried along (2) sensory neurons in bit, all our concentration would be needed just to
the femoral nerve to (3) the spinal cord. In the spinal remain standing. Since these are spinal cord reflexes,
cord, the sensory neurons synapse with (4) motor neu- the brain is not directly involved. The brain may
rons (this is a two-neuron reflex). The motor neurons become aware that a reflex has taken place, but that
in the femoral nerve carry impulses back to (5) the involves another set of neurons carrying impulses to
quadriceps femoris, the effector, which contracts and the brain.
extends the lower leg. Flexor reflexes (or withdrawal reflexes) are
The patellar reflex is one of many used clinically to another type of spinal cord reflex. The stimulus is
determine whether the nervous system is functioning something painful and potentially harmful, and the
properly. If the patellar reflex were absent in a patient, response is to pull away from it. If you inadvertently
the problem could be in the thigh muscle, the femoral touch a hot stove, you automatically pull your hand
nerve, or the spinal cord. Further testing would be away. Flexor reflexes are three-neuron reflexes,
needed to determine the precise break in the reflex because sensory neurons synapse with interneurons in
arc. If the reflex is normal, however, that means that the spinal cord, which in turn synapse with motor
all parts of the reflex arc are intact. So the testing of neurons. Again, however, the brain does not have to
reflexes may be a first step in the clinical assessment of make a decision to protect the body; the flexor reflex
neurologic damage. does that automatically (see Box 8–3: Spinal Cord
You may be wondering why we have such reflexes, Injuries). The brain may know that the reflex has
these stretch reflexes. What is their importance in our taken place, and may even learn from the experience,
everyday lives? Imagine a person standing upright—is but that requires different neurons, not the reflex arc.
BOX 8–3 SPINAL CORD INJURIES
Injuries to the spinal cord are most often caused by need to urinate or defecate. Nor will voluntary con-
auto accidents, falls, and gunshot wounds. The trol of these reflexes be possible, because inhibiting
most serious injury is transection, or severing, of the impulses from the brain can no longer reach the
spinal cord. If, for example, the spinal cord is sev- lower segments of the spinal cord.
ered at the level of the 8th thoracic segment, there Potentially less serious injuries are those in which
will be paralysis and loss of sensation below that the spinal cord is crushed rather than severed, and
level. Another consequence is spinal shock, the at- treatment is aimed at preserving whatever function
least-temporary loss of spinal cord reflexes. In this remains. Minimizing inflammation and stimulating
example, the spinal cord reflexes of the lower trunk the production of nerve growth factors are aspects
and legs will not occur. The stretch reflexes and of such treatment.
flexor reflexes of the legs will be at least temporar- Perhaps the most challenging research is the
ily abolished, as will the urination and defecation attempt to stimulate severed spinal cords to regen-
reflexes. Although these reflexes do not depend erate. Partial success has been achieved in rats
directly on the brain, spinal cord neurons depend and mice, with Schwann cells transplanted from
on impulses from the brain to enhance their own their peripheral nerves and nerve growth factors
ability to generate impulses. produced by genetically engineered cells. The use
As spinal cord neurons below the injury recover of stem cells has also been successful in rats. The
their ability to generate impulses, these reflexes, researchers caution, however, that it will take some
such as the patellar reflex, often return. Urination time before their procedures will be tested on
and defecation reflexes may also be reestablished, people.
but the person will not have an awareness of the
those we think of as vital (as in “vital signs”). The

THE BRAIN medulla contains cardiac centers that regulate heart
rate, vasomotor centers that regulate the diameter of
The brain consists of many parts that function as an
blood vessels and, thereby, blood pressure, and respi-
integrated whole. The major parts are the medulla,
ratory centers that regulate breathing. You can see
pons, and midbrain (collectively called the brain
why a crushing injury to the occipital bone may be
stem), the cerebellum, the hypothalamus, the thala-
rapidly fatal—we cannot survive without the medulla.
mus, and the cerebrum. These parts are shown in Fig.
Also in the medulla are reflex centers for coughing,
8–6. We will discuss each part separately, but keep in
sneezing, swallowing, and vomiting.
mind that they are all interconnected and work
together.
PONS
VENTRICLES The pons bulges anteriorly from the upper part of the
The ventricles are four cavities within the brain: two medulla. Within the pons are two respiratory centers
lateral ventricles, the third ventricle, and the fourth that work with those in the medulla to produce a nor-
ventricle (Fig. 8–7). Each ventricle contains a capillary mal breathing rhythm. (The function of all the respi-
network called a choroid plexus, which forms cere- ratory centers is discussed in Chapter 15.) The many
brospinal fluid (CSF) from blood plasma. Cere- other neurons in the pons ( pons is from the Latin for
brospinal fluid is the tissue fluid of the central nervous “bridge”) connect the medulla with other parts of the
system; its circulation and functions will be discussed brain.
in the section on meninges.
MIDBRAIN
MEDULLA
The midbrain extends from the pons to the hypothal-
The medulla extends from the spinal cord to the pons amus and encloses the cerebral aqueduct, a tunnel
and is anterior to the cerebellum. Its functions are that connects the third and fourth ventricles. Several
Corpus callosum
Parietal lobe
Frontal lobe
Occipital lobe
Choroid plexus in Midbrain

third ventricle
Cerebellum
Thalamus Choroid plexus in
fourth ventricle
Optic nerve
Hypothalamus
Pituitary gland Pons
Temporal lobe
Medulla
Hippocampus
Spinal cord
B Longitudinal fissure
Cerebral cortex
Corpus callosum
Lateral ventricle
Thalamus
Third ventricle
Basal
ganglia
Hypothalamus
Temporal
lobe Optic tracts
Figure 8–6. (A) Midsagittal section of the brain as seen from the left side. This medial
plane shows internal anatomy as well as the lobes of the cerebrum. (B) Frontal section of
the brain in anterior view.
QUESTION: Find the corpus callosum in parts A and B, and describe its shape. What is its
function?
177
Lateral ventricles
Parietal lobe
Occipital lobe
Cerebral aqueduct
Third ventricle
Temporal lobe Fourth ventricle
Cerebellum
Pons
Central canal of spinal cord
Medulla
Figure 8–7. Ventricles of the brain as projected into the interior of the brain, which is
seen from the left side.
QUESTION: Describe the extent of each lateral ventricle.
different kinds of reflexes are integrated in the mid- the impulses for arm movement come from the cere-
brain, including visual and auditory reflexes. If you see brum. The cerebellum then modifies these impulses so
a wasp flying toward you, you automatically duck or that your arm and finger movements are coordinated,
twist away; this is a visual reflex, as is the coordinated and you don’t reach past the pencil.
movement of the eyeballs. Turning your head (ear) to The cerebellum seems also to be involved in certain
a sound is an example of an auditory reflex. The mid- sensory functions. For example, if you close your eyes
brain is also concerned with what are called righting and someone places a tennis ball in one hand and a
reflexes, those that keep the head upright and main- baseball in the other, could you tell which was which?
tain balance or equilibrium. Certainly you could, by the “feel” of each: the texture
and the weight or heft. If you pick up a plastic con-
CEREBELLUM tainer of coffee (with a lid on it) could you tell if the
cup is full, half-full, or empty? Again, you certainly
The cerebellum is separated from the medulla and
could. Do you have to think about it? No. The cere-
pons by the fourth ventricle and is inferior to the
bellum is, in part, responsible for this ability.
occipital lobes of the cerebrum. As you already know,
To regulate equilibrium, the cerebellum (and mid-
many of the functions of the cerebellum are concerned
brain) uses information about gravity and movement
with movement. These include coordination, regula-
provided by receptors in the inner ears. These recep-
tion of muscle tone, the appropriate trajectory and
tors are discussed further in Chapter 9.
endpoint of movements, and the maintenance of pos-
ture and equilibrium. Notice that these are all invol-
HYPOTHALAMUS
untary; that is, the cerebellum functions below the
level of conscious thought. This is important to permit Located superior to the pituitary gland and inferior to
the conscious brain to work without being overbur- the thalamus, the hypothalamus is a small area of the
dened. If you decide to pick up a pencil, for example, brain with many diverse functions:
1. Production of antidiuretic hormone (ADH) and THALAMUS

oxytocin; these hormones are then stored in the
The thalamus is superior to the hypothalamus and
posterior pituitary gland. ADH enables the kidneys
inferior to the cerebrum. The third ventricle is a nar-
to reabsorb water back into the blood and thus
row cavity that passes through both the thalamus and
helps maintain blood volume. Oxytocin causes con-
hypothalamus. Many of the functions of the thalamus
tractions of the uterus to bring about labor and
are concerned with sensation. Sensory impulses to the
delivery.
brain (except those for the sense of smell) follow neu-
2. Production of releasing hormones (also called
ron pathways that first enter the thalamus, which
releasing factors) that stimulate the secretion of
groups the impulses before relaying them to the cere-
hormones by the anterior pituitary gland. Because
brum, where sensations are felt. For example, holding
these hormones are covered in Chapter 10, a single
a cup of hot coffee generates impulses for heat, touch
example will be given here: The hypothalamus pro-
and texture, and the shape of the cup (muscle sense),
duces growth hormone releasing hormone
but we do not experience these as separate sensations.
(GHRH), which stimulates the anterior pituitary
The thalamus integrates the impulses from the cuta-
gland to secrete growth hormone (GH).
neous receptors and from the cerebellum, that is, puts
3. Regulation of body temperature by promoting
them together in a sort of electrochemical package, so
responses such as sweating in a warm environment
that the cerebrum feels the whole and is able to inter-
or shivering in a cold environment (see Chapter
pret the sensation quickly.
17).
Some sensations, especially unpleasant ones such as
4. Regulation of food intake; the hypothalamus is
pain, are believed to be felt by the thalamus. However,
believed to respond to changes in blood nutrient
the thalamus cannot localize the sensation; that is, it
levels, to chemicals secreted by fat cells, and to hor-
does not know where the painful sensation is. The
mones secreted by the gastrointestinal tract. For
sensory areas of the cerebrum are required for local-
example, during a meal, after a certain duration of
ization and precise awareness.
digestion, the small intestine produces a hormone
The thalamus may also suppress unimportant
that circulates to the hypothalamus and brings
sensations. If you are reading an enjoyable book, you
about a sensation of satiety, or fullness, and we tend
may not notice someone coming into the room. By
to stop eating.
temporarily blocking minor sensations, the thalamus
5. Integration of the functioning of the autonomic
permits the cerebrum to concentrate on important
nervous system, which in turn regulates the activity
tasks.
of organs such as the heart, blood vessels, and
Parts of the thalamus are also involved in alertness
intestines. This will be discussed in more detail
and awareness (being awake and knowing we are), and
later in this chapter.
others contribute to memory. For these functions, as
6. Stimulation of visceral responses during emotional
for others, the thalamus works very closely with the
situations. When we are angry, heart rate usually
cerebrum.
increases. Most of us, when embarrassed, will blush,
which is vasodilation in the skin of the face. These
CEREBRUM
responses are brought about by the autonomic
nervous system when the hypothalamus perceives a The largest part of the human brain is the cerebrum,
change in emotional state. The neurologic basis of which consists of two hemispheres separated by the
our emotions is not well understood, and the vis- longitudinal fissure. At the base of this deep groove is
ceral responses to emotions are not something most the corpus callosum, a band of 200 million neurons
of us can control. that connects the right and left hemispheres. Within
7. Regulation of body rhythms such as secretion of each hemisphere is a lateral ventricle.
hormones, sleep cycles, changes in mood, or men- The surface of the cerebrum is gray matter called
tal alertness. This is often referred to as our bio- the cerebral cortex. Gray matter consists of cell bod-
logical clock, the rhythms as circadian rhythms, ies of neurons, which carry out the many functions of
meaning “about a day.” If you have ever had to stay the cerebrum. Internal to the gray matter is white
awake for 24 hours, you know how disorienting it matter, made of myelinated axons and dendrites that
can be, until the hypothalamic biological clock has connect the lobes of the cerebrum to one another and
been reset. to all other parts of the brain.
In the human brain the cerebral cortex is folded Frontal Lobes

extensively. The folds are called convolutions or
gyri and the grooves between them are fissures or Within the frontal lobes are the motor areas that
sulci (you can see the folding of the cortex in the generate the impulses for voluntary movement. The
frontal section of the brain in Fig. 8–6). This fold- largest portions are for movement of the hands and
ing permits the presence of millions more neurons in face, those areas with many muscles capable of very
the cerebral cortex. The cerebral cortex of an animal fine or precise movements. It is the large size of the
such as a dog or cat does not have this extensive motor area devoted to them that gives these muscles
folding. This difference enables us to read, speak, their precision. The left motor area controls move-
do long division, write poetry and songs, and do ment on the right side of the body, and the right
so many other “human” things that dogs and cats can- motor area controls the left side of the body. This is
not do. why a patient who has had a cerebrovascular accident,
The cerebral cortex is divided into lobes that have or stroke, in the right frontal lobe will have paralysis
the same names as the cranial bones external to them. of muscles on the left side (see Box 8–4: Cerebrovas-
Therefore, each hemisphere has a frontal lobe, pari- cular Accidents).
etal lobe, temporal lobe, and occipital lobe (Fig. 8–8). Anterior to the motor areas are the premotor
These lobes have been mapped; that is, certain areas areas, which are concerned with learned motor skills
are known to be associated with specific functions. We that require a sequence of movements. Tying shoe-
will discuss the functions of the cerebrum according to laces, for example, seems almost automatic to us; we
these mapped areas. forget having learned it. It is not a reflex, however;
Motor area
Premotor area General sensory area
Frontal lobe
Sensory association
area
Orbitofrontal Parietal lobe

cortex
Occipital lobe
Visual association
area
Visual area
Motor speech area
Auditory
association
area Auditory area
Temporal lobe
Figure 8–8. Left cerebral hemisphere showing some of the functional areas that have
been mapped.
QUESTION: What sensations are felt in the general sensory area?
BOX 8–4 CEREBROVASCULAR ACCIDENTS
A cerebrovascular accident (CVA), or stroke, is they cause is very widespread or affects vital centers
damage to a blood vessel in the brain, resulting in in the medulla or pons.
lack of oxygen to that part of the brain. Possible For CVAs of the thrombus type, a clot-dissolving
types of vessel damage are thrombosis or hemor- drug may help reestablish blood flow. To be effec-
rhage. tive, however, the drug must be administered
A thrombus is a blood clot, which most often is within 3 hours of symptom onset (see also Box
a consequence of atherosclerosis, abnormal lipid 11–7).
deposits in cerebral arteries. The rough surface Recovery from a CVA depends on its location
stimulates clot formation, which obstructs the and the extent of damage, as well as other factors.
blood flow to the part of the brain supplied by One of these is the redundancy of the brain.
the artery. The symptoms depend on the part of the Redundancy means repetition or exceeding what
brain affected and may be gradual in onset if clot is necessary; the cerebral cortex has many more
formation is slow. Approximately 80% of CVAs are neurons than we actually use in daily activities.
of this type. The characteristic of plasticity means that these
A hemorrhage, the result of arteriosclerosis or neurons are available for use, especially in younger
aneurysm of a cerebral artery, allows blood out people (less than 50 years of age). When a patient
into brain tissue, which destroys brain neurons by recovers from a disabling stroke, what has often
putting excessive pressure on them as well as happened is that the brain has established new
depriving them of oxygen. Onset of symptoms in pathways, with previously little-used neurons now
this type of CVA is usually rapid. carrying impulses “full time.” Such recovery is
If, for example, the CVA is in the left frontal lobe, highly individual and may take months. Yet another
paralysis of the right side of the body will occur. important factor is that CVA patients be started on
Speech may also be affected if the speech areas are rehabilitation therapy as soon as their condition
involved. Some CVAs are fatal because the damage permits.
rather the premotor cortex has learned the sequence Parietal Lobes
so well that we are able to repeat it without con-
The general sensory areas in the parietal lobes
sciously thinking about it.
receive impulses from receptors in the skin and feel
The parts of the frontal lobes just behind the eyes
and interpret the cutaneous sensations. The left area is
are the prefrontal or orbitofrontal cortex. This area
for the right side of the body and vice versa. These
is concerned with things such as keeping emotional
areas also receive impulses from stretch receptors in
responses appropriate to the situation, realizing that
muscles for conscious muscle sense. The largest por-
there are standards of behavior (laws or rules of a
tions of these areas are for sensation in the hands and
game or simple courtesy) and following them, and
face, those parts of the body with the most cutaneous
anticipating and planning for the future. An example
receptors and the most muscle receptors. The taste
may be helpful to put all this together: Someone with
areas, which overlap the parietal and temporal lobes,
damage to the prefrontal area might become enraged
receive impulses from taste buds on the tongue and
if his pen ran out of ink during class, might throw the
elsewhere in the oral cavity.
pen at someone, and might not think that a pen will be
needed tomorrow and that it is time to go buy one. As
Temporal Lobes
you can see, the prefrontal cortex is very important for
social behavior, and greatly contributes to what makes The olfactory areas in the temporal lobes receive
us human. impulses from receptors in the nasal cavities for the
Also in the frontal lobe, usually only the left lobe sense of smell. The olfactory association area learns
for most right-handed people, is Broca’s motor the meaning of odors such as the smell of sour milk, or
speech area, which controls the movements of the fire, or brownies baking in the oven, and enables the
mouth involved in speaking. thinking cerebrum to use that information effectively.
The auditory areas, as their name suggests, receive as not to be late to class. Other parts of the occipital
impulses from receptors in the inner ear for hearing. lobes are concerned with spatial relationships; things
The auditory association area is quite large. Part of it such as judging distance and seeing in three dimen-
is concerned with the meanings of words we hear, that sions, or the ability to read a map and relate it to the
is, with speech. Other parts are for the interpretation physical world.
of sounds such as thunder during a storm, an ambu- The cerebral cortex has the characteristic of neural
lance siren, or a baby crying. Without proper interpre- plasticity, the ability to adapt to changing needs, to
tation, we would hear the sound but would not know recruit different neurons for certain functions, as may
what it meant, and could not respond appropriately. occur during childhood or recovery from a stroke.
Also in the temporal and parietal lobes in the left Another example is the visual cortex of a person who
hemisphere (for most of us) are other speech areas is born blind. The neurons in the occipital lobes that
concerned with the thought that precedes speech. would have been used for vision will often be used for
Each of us can probably recall (and regret) times when another function; some may become part of an audi-
we have “spoken without thinking,” but in actuality tory area that is used to localize sounds and estimate
that is not possible. The thinking takes place very rap- their distance. Those of us who can see may not rely
idly and is essential in order to be able to speak (see on hearing for localization; we simply look at where
Box 8–5: Aphasia). we think the sound came from. A blind person cannot
do this, and may have an extensive mental catalogue of
Occipital Lobes sounds, meanings of sounds, distances of sounds, and
so on, some of these in the part of the cortex that nor-
Impulses from the retinas of the eyes travel along the
mally is for vision.
optic nerves to the visual areas in the occipital lobes.
The younger the person, the more plastic the brain.
These areas “see.” The visual association areas inter-
The brains of children are extraordinarily adaptable.
pret what is seen, and enable the thinking cerebrum to
As we get older, this ability diminishes, but is still
use the information. Imagine looking at a clock.
present.
Seeing the clock is far different from being able to
interpret it. At one time we learned to interpret the
Association Areas
clock face and hands, and now we do not have to con-
sciously decide what time the clock is reading. We can As you can see in Fig. 8–8, many parts of the cerebral
simply use that information, such as hurrying a bit so cortex are not concerned with movement or a particu-
BOX 8–5 APHASIA
Our use of language sets us apart from other Auditory aphasia is “word deafness,” caused
animals and involves speech, reading, and writing. by damage to an interpretation area. The person
Language is the use of symbols (words) to desig- can still hear but cannot comprehend what the
nate objects and to express ideas. Damage to words mean. Visual aphasia is “word blindness”;
the speech areas or interpretation areas of the the person can still see perfectly well, but can-
cerebrum may impair one or more aspects of a per- not make sense of written words (the person retains
son’s ability to use language; this is called aphasia. the ability to understand spoken words). Imagine
Aphasia may be a consequence of a cerebrovas- how you would feel if wms qsbbcljw jmqr rfc
cular accident, or of physical trauma to the skull yzgjgrw rm pcyb. Frustrating isn’t it? You know
and brain such as a head injury sustained in an that those symbols are letters, but you cannot
automobile accident. If the motor speech (Broca’s) “decode” them right away. Those “words”
area is damaged, the person is still able to under- were formed by shifting the alphabet two letters
stand written and spoken words and knows what (A ⫽ C, B ⫽ D, C ⫽ E, etc.), and would normally
he wants to say, but he cannot say it. Without coor- be read as: “you suddenly lost the ability to read.”
dination and impulses from the motor speech area, That may give you a small idea of what word blind-
the muscles used for speech cannot contract to ness is like.
form words properly.
lar sensation. These may be called association areas experienced or learned is stored somewhere in the
and perhaps are what truly make us individuals. It is brain. Sometimes a trigger may bring back memories;
probably these areas that give each of us a personality, a certain scent or a song could act as possible triggers.
a sense of humor, and the ability to reason and use Then we find ourselves recalling something from the
logic. Learning and memory are also functions of past and wondering where it came from.
these areas. The loss of personality due to destruction of
Although much has been learned about the forma- brain neurons is perhaps most dramatically seen in
tion of memories, the processes are still incompletely Alzheimer’s disease (see Box 8–6: Alzheimer’s Disease).
understood and mostly beyond the scope of this book.
Briefly, however, we can say that memories of things
Basal Ganglia
such as people or books or what you did last summer
involve the hippocampus (from the Greek for The basal ganglia are paired masses of gray matter
“seahorse,” because of its shape), part of the temporal within the white matter of the cerebral hemispheres
lobe on the floor of the lateral ventricle. The two hip- (see Fig. 8–6). Their functions are certain subcon-
pocampi seem to collect information from many areas scious aspects of voluntary movement, and they work
of the cerebral cortex. When you meet a friend, for with the cerebellum. The basal ganglia help regulate
example, the memory emerges as a whole: “Here’s muscle tone, and they coordinate accessory move-
Fred,” not in pieces. People whose hippocampi are ments such as swinging the arms when walking or ges-
damaged cannot form new memories that last more turing while speaking. The most common disorder of
than a few seconds. the basal ganglia is Parkinson’s disease (see Box 8–7:
The right hippocampus is also believed to be Parkinson’s Disease).
involved in spatial cognition (literally: “space think-
ing”). For example, if you are in school and a friend
Corpus Callosum
asks you the shortest way to your home, you will prob-
ably quickly form a mental map. You can see how As mentioned previously, the corpus callosum is a
much memory that involves (streets, landmarks, and band of nerve fibers that connects the left and right
so on), but the hippocampus can take it a step further cerebral hemispheres. This enables each hemisphere
and make your memories three-dimensional and men- to know of the activity of the other. This is especially
tally visible. You can see your way home. That is spa- important for people because for most of us, the left
tial cognition. hemisphere contains speech areas and the right hemi-
It is believed that most, if not all, of what we have sphere does not. The corpus callosum, therefore, lets
BOX 8–6 ALZHEIMER’S DISEASE
In the United States, Alzheimer’s disease, a pro- of another protein called beta-amyloid that are
gressive, incurable form of mental deterioration, damaging to neurons.
affects approximately 5 million people and is the A defective gene has been found in some
cause of 100,000 deaths each year. The first symp- patients who have late-onset Alzheimer’s disease,
toms, which usually begin after age 65, are mem- the most common type. Yet another gene seems to
ory lapses and slight personality changes. As the trigger increased synthesis of beta-amyloid. Some
disease progresses, there is total loss of memory, research is focused on the interaction of these
reasoning ability, and personality, and those with genes and on inflammation as a contributing factor
advanced disease are unable to perform even the to this type of brain damage.
simplest tasks or self-care. It is likely that the treatment of Alzheimer’s dis-
Structural changes in the brains of Alzheimer’s ease will one day mean delaying its onset with a
patients may be seen at autopsy. Neurofibrillary variety of medications, each targeted at a different
tangles are abnormal fibrous proteins found in cells aspect of this complex disease. Early diagnosis will
of the cerebral cortex in areas important for mem- be very important, and this is yet another avenue of
ory and reasoning. Also present are plaques made research.
BOX 8–7 PARKINSON’S DISEASE MENINGES AND

Parkinson’s disease is a disorder of the basal
CEREBROSPINAL FLUID
ganglia whose cause is unknown, and though
there is a genetic component in some families, it The connective tissue membranes that cover the brain
is probably not the only factor. The disease usu- and spinal cord are called meninges; the three layers
ally begins after the age of 60. Neurons in the are illustrated in Fig. 8–9. The thick outermost layer,
basal ganglia that produce the neurotransmitter made of fibrous connective tissue, is the dura mater
dopamine begin to degenerate and die, and the (Latin for “tough mother”), which lines the skull and
deficiency of dopamine causes specific kinds vertebral canal. The middle arachnoid membrane
of muscular symptoms. Tremor, or involuntary
(arachnids are spiders) is made of web-like strands of
shaking, of the hands is probably the most com-
mon symptom. The accessory movements regu-
connective tissue. The innermost pia mater (Latin for
lated by the basal ganglia gradually diminish, “gentle mother”) is a very thin membrane on the sur-
and the affected person walks slowly without face of the spinal cord and brain. Between the arach-
swinging the arms. A mask-like face is character- noid and the pia mater is the subarachnoid space,
istic of this disease, as the facial muscles become which contains cerebrospinal fluid (CSF), the tissue
rigid. Eventually all voluntary movements be- fluid of the central nervous system.
come slower and much more difficult, and bal- Recall the ventricles (cavities) of the brain: two lat-
ance is seriously impaired. eral ventricles, the third ventricle, and the fourth ven-
Dopamine itself cannot be used to treat tricle. Each contains a choroid plexus, a capillary
Parkinson’s disease because it does not cross the network that forms cerebrospinal fluid from blood
blood–brain barrier. A substance called L-dopa
plasma. This is a continuous process, and the cere-
does cross and can be converted to dopamine by
brain neurons. Unfortunately, L-dopa begins to
brospinal fluid then circulates in and around the cen-
lose its therapeutic effectiveness within a few tral nervous system (Fig. 8–10).
years. From the lateral and third ventricles, cerebrospinal
Other medications in use do not provide a fluid flows through the fourth ventricle, then to the
cure. Some researchers suggest that implants of central canal of the spinal cord, and to the cranial and
stem cells may offer the best hope of meaningful spinal subarachnoid spaces. As more cerebrospinal
therapy. fluid is formed, you might expect that some must be
reabsorbed, and that is just what happens. From the
cranial subarachnoid space, cerebrospinal fluid is reab-
the left hemisphere know what the right hemisphere is sorbed through arachnoid villi into the blood in
thinking about, and the right hemisphere know what cranial venous sinuses (large veins within the
the left hemisphere is thinking and talking about. A double-layered cranial dura mater). The cerebrospinal
brief example may be helpful. If you put your left hand fluid becomes blood plasma again, and the rate of
behind your back and someone places a pencil in your reabsorption normally equals the rate of production.
hand (you are not looking at it) and asks you what it is, Since cerebrospinal fluid is tissue fluid, one of its
would you be able to say? Yes, you would. You would functions is to bring nutrients to CNS neurons and to
feel the shape and weight of the pencil, find the point remove waste products to the blood as the fluid is
and the eraser. The sensory impulses from your left reabsorbed. The other function of cerebrospinal fluid
hand are interpreted as “pencil” by the general sensory is to act as a cushion for the central nervous system.
area in your right parietal lobe. Your right hemisphere The brain and spinal cord are enclosed in fluid-filled
probably cannot speak, but its thoughts can be con- membranes that absorb shock. You can, for example,
veyed by way of the corpus callosum to the left hemi- shake your head vigorously without harming your
sphere, which does have speech areas. Your left brain. Naturally, this protection has limits; very sharp
hemisphere can say that you are holding a pencil. or heavy blows to the skull will indeed cause damage
Other aspects of the “division of labor” of our cerebral to the brain.
hemispheres are beyond the scope of this book, but it Examination of cerebrospinal fluid may be used in
is a fascinating subject that you may wish to explore the diagnosis of certain diseases (see Box 8–8: Lumbar
further. Puncture).
Central canal
Gray matter
White matter
Spinal nerve roots
Dorsal root ganglion

Pia mater
Spinal nerve
Arachnoid Subarachnoid
membrane space
Dura
mater
Superior sagittal sinus

Dura mater
Skull
Arachnoid villi
Skin
Cerebral cortex
Cerebrum
(white matter)
Arachnoid membrane
Subarachnoid space
Pia mater
Figure 8–9. Structure of the meninges. (A) Meninges of the spinal cord. (B) Frontal sec-
tion through the top of the skull showing the double-layered cranial dura mater and one
of the cranial venous sinuses.
QUESTION: Describe the structural difference between the spinal dura mater and the cra-
nial dura mater.
185
Dura mater
Cranial Arachnoid Cranial venous sinus
meninges Arachnoid villus
Pia mater
Cerebrum
Subarachnoid space
Corpus
callosum
Lateral
ventricle
Cerebellum
Choroid plexus of
lateral ventricle Cerebral aqueduct
Choroid plexus of Fourth ventricle
third ventricle
Choroid plexus of
fourth ventricle
Third ventricle Pons
Subarachnoid space
Medulla Central canal
Hypothalamus
Spinal cord
Pia mater
Spinal meninges Arachnoid
Dura mater
Subarachnoid space
Figure 8–10. Formation, circulation, and reabsorption of cerebrospinal fluid. See text for
description.
QUESTION: In this pathway, where is the CSF reabsorbed, and into what?
ing the head. Some, however, have more far-reaching

CRANIAL NERVES destinations.
The impulses for the senses of smell, taste, sight,
The 12 pairs of cranial nerves emerge from the brain hearing, and equilibrium are all carried by cranial
stem or other parts of the brain—they are shown in nerves to their respective sensory areas in the brain.
Fig. 8–11. The name cranial indicates their origin, and Some cranial nerves carry motor impulses to muscles
many of them do carry impulses for functions involv- of the face and eyes or to the salivary glands. The
BOX 8–8 LUMBAR PUNCTURE
A lumbar puncture (spinal tap) is a diagnostic cells. A few WBCs in CSF is normal, because WBCs
procedure that involves the removal of cere- are found in all tissue fluid.
brospinal fluid to determine its pressure and con- Another abnormal constituent of cerebrospinal
stituents. As the name tells us, the removal, using a fluid is red blood cells. Their presence indicates
syringe, is made in the lumbar area. Because the bleeding somewhere in the central nervous system.
spinal cord ends between the 1st and 2nd lumbar There may be many causes, and again, further test-
vertebrae, the needle is usually inserted between ing would be necessary.
the 4th and 5th lumbar vertebrae. The meningeal
sac containing cerebrospinal fluid extends to the
end of the lumbar vertebrae, permitting access to
the cerebrospinal fluid with little chance of damag-
ing the spinal cord.
Cerebrospinal fluid is a circulating fluid and has
a normal pressure of 70 to 200 mmH2O. An abnor-
mal pressure usually indicates an obstruction in cir-
culation, which may be caused by infection, a
tumor, or mechanical injury. Other diagnostic
tests would be needed to determine the precise
cause.
Perhaps the most common reason for a lumbar
Box Figure 8–B Cerebrospinal fluid from a patient with
puncture is suspected meningitis, which may be
meningitis. The bacteria are streptococci, found in pairs. The
caused by several kinds of bacteria. If the patient
large cells are WBCs. (⫻500) (From Sacher, RA, and
does have meningitis, the cerebrospinal fluid will be McPherson, RA: Widmann’s Clinical Interpretation of
cloudy rather than clear and will be examined for Laboratory Tests, ed. 11. FA Davis, Philadelphia, 2000, Plate
the presence of bacteria and many white blood 52, with permission.)
vagus nerves (vagus means “wanderer”) branch exten- parasympathetic. Often, they function in opposition
sively to the larynx, heart, stomach and intestines, and to each other, as you will see. The activity of both divi-
bronchial tubes. sions is integrated by the hypothalamus, which
The functions of the cranial nerves are summarized ensures that the visceral effectors will respond appro-
in Table 8–4. priately to the situation.
AUTONOMIC PATHWAYS
THE AUTONOMIC
An autonomic nerve pathway from the central nervous
NERVOUS SYSTEM system to a visceral effector consists of two motor
neurons that synapse in a ganglion outside the CNS
The autonomic nervous system (ANS) is actually (Fig. 8–12). The first neuron is called the pregan-
part of the peripheral nervous system in that it consists glionic neuron, from the CNS to the ganglion. The
of motor portions of some cranial and spinal nerves. second neuron is called the postganglionic neuron,
Because its functioning is so specialized, however, the from the ganglion to the visceral effector. The ganglia
autonomic nervous system is usually discussed as a are actually the cell bodies of the postganglionic
separate entity, as we will do here. neurons.
Making up the autonomic nervous system are vis-
ceral motor neurons to smooth muscle, cardiac mus-
SYMPATHETIC DIVISION
cle, and glands. These are the visceral effectors;
muscle will either contract or relax, and glands will Another name for the sympathetic division is thora-
either increase or decrease their secretions. columbar division, which tells us where the sympa-
The ANS has two divisions: sympathetic and thetic preganglionic neurons originate. Their cell
Optic
chiasma
Figure 8–11. Cranial

nerves and their distributions.
The brain is shown in an infe-
rior view. See Table 8–4 for
descriptions.
QUESTION: Which cranial
nerves bring about secretion
of saliva? Which nerve brings
about gastric and intestinal
secretion?
bodies are in the thoracic segments and some of the The sympathetic division is dominant in stressful
lumbar segments of the spinal cord. Their axons situations, which include anger, fear, or anxiety, as
extend to the sympathetic ganglia, most of which are well as exercise. For our prehistoric ancestors, stress-
located in two chains just outside the spinal column ful situations often involved the need for intense phys-
(see Fig. 8–12). Within the ganglia are the synapses ical activity—the “fight or flight response.” Our
between preganglionic and postganglionic neurons; nervous systems haven’t changed very much in 50,000
the postganglionic axons then go to the visceral effec- years, and if you look at Table 8–5, you will see the
tors. One preganglionic neuron often synapses with kinds of responses the sympathetic division stimulates.
many postganglionic neurons to many effectors. This The heart rate increases, vasodilation in skeletal mus-
anatomic arrangement has physiological importance: cles supplies them with more oxygen, the bronchioles
The sympathetic division brings about widespread dilate to take in more air, and the liver changes glyco-
responses in many organs. gen to glucose to supply energy. At the same time,
Table 8–4 CRANIAL NERVES
Number and Name Function(s)
I Olfactory • Sense of smell

II Optic • Sense of sight
III Oculomotor • Movement of the eyeball; constriction of pupil in bright light or for near vision
IV Trochlear • Movement of eyeball
V Trigeminal • Sensation in face, scalp, and teeth; contraction of chewing muscles
VI Abducens • Movement of the eyeball
VII Facial • Sense of taste; contraction of facial muscles; secretion of saliva
VIII Acoustic (vestibulocochlear) • Sense of hearing; sense of equilibrium
IX Glossopharyngeal • Sense of taste; sensory for cardiac, respiratory, and blood pressure reflexes;
contraction of pharynx; secretion of saliva
X Vagus • Sensory in cardiac, respiratory, and blood pressure reflexes; sensory and motor
to larynx (speaking); decreases heart rate; contraction of alimentary tube
(peristalsis); increases digestive secretions
XI Accessory • Contraction of neck and shoulder muscles; motor to larynx (speaking)
XII Hypoglossal • Movement of the tongue
digestive secretions decrease and peristalsis slows; The parasympathetic division dominates in relaxed
these are not important in a stress situation. (non-stress) situations to promote normal functioning
Vasoconstriction in the skin and viscera shunts blood of several organ systems. Digestion will be efficient,
to more vital organs such as the heart, muscles, and with increased secretions and peristalsis; defecation
brain. All of these responses enabled our ancestors to and urination may occur; and the heart will beat at a
stay and fight or to get away from potential danger. normal resting rate. Other functions of this division
Even though we may not always be in life-threatening are listed in Table 8–5.
situations during stress (such as figuring out our Notice that when an organ receives both sympa-
income taxes), our bodies are prepared for just that. thetic and parasympathetic impulses, the responses are
opposites. Such an arrangement makes maintaining an
appropriate level of activity quite simple, as in chang-
PARASYMPATHETIC DIVISION ing the heart rate to meet the needs of a situation.
Notice also that some visceral effectors receive only
The other name for the parasympathetic division is
sympathetic impulses. In such cases, the opposite
the craniosacral division. The cell bodies of parasym-
response is brought about by a decrease in sympathetic
pathetic preganglionic neurons are in the brain stem
impulses. Secretion by the sweat glands is an example.
and the sacral segments of the spinal cord. Their axons
are in cranial nerve pairs 3, 7, 9, and 10 and in some
sacral nerves and extend to the parasympathetic gan-
NEUROTRANSMITTERS
glia. These ganglia are very close to or actually in the
visceral effector (see Fig. 8–12), and contain the post- Recall that neurotransmitters enable nerve impulses to
ganglionic cell bodies, with very short axons to the cross synapses. In autonomic pathways there are two
cells of the effector. synapses: one between preganglionic and postgan-
In the parasympathetic division, one preganglionic glionic neurons, and the second between postgan-
neuron synapses with just a few postganglionic neurons glionic neurons and visceral effectors.
to only one effector. With this anatomic arrangement, Acetylcholine is the transmitter released by all
very localized (one organ) responses are possible. preganglionic neurons, both sympathetic and para-
Sympathetic Parasympathetic
Eye
Ciliary ganglion
III
Midbrain
Pterygopalatine
ganglion VII
Pons
IX
Salivary Medulla
glands Otic
Trachea Submandibular ganglion
ganglion
X
Preganglionic neurons Vagus nerve

Postganglionic
neurons
T1
T2 Preganglionic
T3 Bronchioles neuron
T4 Heart
Celiac ganglion
T5
Adrenal gland Postganglionic
T6 neuron
Stomach
T7
T8 Kidney
T9 Pancreas
T10 Superior
mesenteric
Small
T11 ganglion
intestine
Large
T12 intestine
L1
Colon
L2
Rectum
Chain of
sympathetic Inferior
ganglia mesenteric
ganglion
Bladder S2
S3
Reproductive S4
organs
Figure 8–12. The autonomic nervous system. The sympathetic division is shown on the
left, and the parasympathetic division is shown on the right (both divisions are bilateral).
QUESTION: Do both or just one division of the ANS supply the heart? What is the purpose
of this arrangement?
190
Table 8–5 FUNCTIONS OF THE AUTONOMIC NERVOUS SYSTEM
Organ Sympathetic Response Parasympathetic Response
Heart (cardiac muscle) • Increase rate • Decrease rate (to normal)

Bronchioles (smooth muscle) • Dilate • Constrict (to normal)
Iris (smooth muscle) • Pupil dilates • Pupil constricts (to normal)
Salivary glands • Decrease secretion • Increase secretion (to normal)
Stomach and intestines (smooth muscle) • Decrease peristalsis • Increase peristalsis for normal digestion
Stomach and intestines (glands) • Decrease secretion • Increase secretion for normal digestion
Internal anal sphincter • Contracts to prevent defecation • Relaxes to permit defecation
Urinary bladder (smooth muscle) • Relaxes to prevent urination • Contracts for normal urination
Internal urethral sphincter • Contracts to prevent urination • Relaxes to permit urination
Liver • Changes glycogen to glucose • None
Pancreas • Secretes glucagon • Secretes insulin and digestive enzymes
Sweat glands • Increase secretion • None
Blood vessels in skin and viscera • Constrict • None
(smooth muscle)
Blood vessels in skeletal muscle • Dilate • None
(smooth muscle)
Adrenal glands • Increase secretion of epineph- • None
rine and norepinephrine
sympathetic; it is inactivated by cholinesterase in ing a car, an ability most of us take for granted. For
postganglionic neurons. Parasympathetic postgan- elderly people, with their slower perceptions and reac-
glionic neurons all release acetylcholine at the tion times, greater consciousness of driving is necessary.
synapses with their visceral effectors. Most sympa- As the autonomic nervous system ages, dry eyes and
thetic postganglionic neurons release the transmitter constipation may become problems. Transient hypo-
norepinephrine at the synapses with the effector cells. tension may be the result of decreased sympathetic
Norepinephrine is inactivated by either catechol-O- stimulation of vasoconstriction. In most cases, how-
methyl transferase (COMT) or monoamine oxidase ever, elderly people who are aware of these aspects of
(MAO), or it may be removed from the synapse by aging will be able to work with their physicians or
reuptake. nurses to adapt to them.
AGING AND THE SUMMARY

NERVOUS SYSTEM
The nervous system regulates many of our simplest
The aging brain does lose neurons, but this is only a and our most complex activities. The impulses gener-
small percentage of the total and not the usual cause of ated and carried by the nervous system are an example
mental impairment in elderly people. (Far more com- of the chemical level of organization of the body.
mon causes are depression, malnutrition, hypotension, These nerve impulses then regulate the functioning of
and the side effects of medications.) Some forgetful- tissues, organs, and organ systems, which permits us to
ness is to be expected, however, as is a decreased abil- perceive and respond to the world around us and the
ity for rapid problem solving, but most memory changes within us. The detection of such changes is
should remain intact. Voluntary movements become the function of the sense organs, and they are the sub-
slower, as do reflexes and reaction time. Think of driv- ject of our next chapter.
STUDY OUTLINE
Functions of the Nervous System 3. Mixed nerve—made of both sensory and motor
1. Detect changes and feel sensations. neurons.
2. Initiate responses to changes. 4. Nerve tract—a nerve within the CNS; also called
3. Organize and store information. white matter.
Nervous System Divisions The Nerve Impulse—see Table 8–2

1. Central nervous system (CNS)—brain and spinal 1. Polarization—neuron membrane has a (⫹) charge
cord. outside and a (⫺) charge inside.
2. Peripheral nervous system (PNS)—cranial nerves 2. Depolarization—entry of Na⫹ ions and reversal of
and spinal nerves. charges on either side of the membrane.
3. Impulse transmission is rapid, often several meters
Nerve Tissue—neurons (nerve fibers) and per second.
specialized cells (Schwann, neuroglia) • Saltatory conduction—in a myelinated neuron
1. Neuron cell body contains the nucleus; cell bodies only the nodes of Ranvier depolarize; increases
are in the CNS or in the trunk and are protected by speed of impulses.
bone.
2. Axon carries impulses away from the cell body; The Spinal Cord
dendrites carry impulses toward the cell body. 1. Functions: transmits impulses to and from the
3. Schwann cells in PNS: Layers of cell membrane brain, and integrates the spinal cord reflexes.
form the myelin sheath to electrically insulate neu- 2. Location: within the vertebral canal; extends from
rons; nodes of Ranvier are spaces between adjacent the foramen magnum to the disc between the 1st
Schwann cells. Nuclei and cytoplasm of Schwann and 2nd lumbar vertebrae.
cells form the neurolemma, which is essential for 3. Cross-section: internal H-shaped gray matter con-
regeneration of damaged axons or dendrites. tains cell bodies of motor neurons and interneu-
4. Oligodendrocytes in CNS form the myelin rons; external white matter is the myelinated axons
sheaths; microglia phagocytize pathogens and and dendrites of interneurons.
damaged cells; astrocytes contribute to the 4. Ascending tracts carry sensory impulses to the
blood–brain barrier (see Table 8–1). brain; descending tracts carry motor impulses away
5. Synapse—the space between the axon of one neu- from the brain.
ron and the dendrites or cell body of the next neu- 5. Central canal contains cerebrospinal fluid and is
ron. A neurotransmitter carries the impulse across continuous with the ventricles of the brain.
a synapse and is then destroyed by a chemical inac-
tivator. Synapses make impulse transmission one Spinal Nerves—see Table 8–3 for major
way in the living person. peripheral nerves
1. Eight cervical pairs to head, neck, shoulder, arm,
Types of Neurons—nerve fibers and diaphragm; 12 thoracic pairs to trunk; 5 lum-
1. Sensory—carry impulses from receptors to the bar pairs and 5 sacral pairs to hip, pelvic cavity, and
CNS; may be somatic (from skin, skeletal muscles, leg; 1 very small coccygeal pair.
joints) or visceral (from internal organs). 2. Cauda equina—the lumbar and sacral nerves that
2. Motor—carry impulses from the CNS to effectors; extend below the end of the spinal cord.
may be somatic (to skeletal muscle) or visceral (to 3. Each spinal nerve has two roots: dorsal or sensory
smooth muscle, cardiac muscle, or glands). Visceral root; dorsal root ganglion contains cell bodies of
motor neurons make up the autonomic nervous sensory neurons; ventral or motor root; the two
system. roots unite to form a mixed spinal nerve.
3. Interneurons—entirely within the CNS.
Spinal Cord Reflexes—do not depend directly
Nerves and Nerve Tracts on the brain
1. Sensory nerve—made only of sensory neurons. 1. A reflex is an involuntary response to a stimulus.
2. Motor nerve—made only of motor neurons. 2. Reflex arc—the pathway of nerve impulses during a
reflex: (1) receptors, (2) sensory neurons, (3) CNS the surface gray matter, which consists of cell bod-
with one or more synapses, (4) motor neurons, ies of neurons and is folded extensively into convo-
(5) effector that responds. lutions. The internal white matter consists of nerve
3. Stretch reflex—a muscle that is stretched will contracts that connect the lobes of the cerebrum to one
tract; these reflexes help keep us upright against another and to other parts of the brain.
gravity. The patellar reflex is also used clinically to • Frontal lobes—motor areas initiate voluntary
assess neurologic functioning, as are many other movement; premotor area regulates sequences of
reflexes (Fig. 8–5). movements for learned skills; prefrontal area for
4. Flexor reflex—a painful stimulus will cause with- aspects of social behavior; Broca’s motor speech
drawal of the body part; these reflexes are protec- area (left hemisphere) regulates the movements
tive. involved in speech.
• Parietal lobes—general sensory area feels and
The Brain—many parts that function as an interprets the cutaneous senses and conscious
integrated whole; see Figs. 8–6 and 8–8 for muscle sense; taste area extends into temporal
locations lobe, for sense of taste; speech areas (left hemi-
1. Ventricles—four cavities: two lateral, 3rd, 4th; each sphere) for thought before speech.
contains a choroid plexus that forms cerebrospinal • Temporal lobes—auditory areas for hearing and
fluid (Figs. 8–6 and 8–7). interpretation; olfactory areas for sense of smell
2. Medulla—regulates the vital functions of heart and interpretation; speech areas for thought
rate, breathing, and blood pressure; regulates before speech.
reflexes of coughing, sneezing, swallowing, and • Occipital lobes—visual areas for vision; interpre-
vomiting. tation areas for spatial relationships.
3. Pons—contains respiratory centers that work with • Association areas—in all lobes, for abstract
those in the medulla. thinking, reasoning, learning, memory, and
4. Midbrain—contains centers for visual reflexes, personality. The hippocampi are essential for
auditory reflexes, and righting (equilibrium) the formation of memories. Neural plasticity is
reflexes. the ability of the brain to adapt to changing
5. Cerebellum—regulates coordination of voluntary needs.
movement, muscle tone, stopping movements, and • Basal ganglia—gray matter within the cerebral
equilibrium; contributes to sensations involving hemispheres; regulate accessory movements and
texture and weight. muscle tone.
6. Hypothalamus—produces antidiuretic hormone
(ADH), which increases water reabsorption by the
kidneys; produces oxytocin, which promotes uter- Meninges and Cerebrospinal Fluid (CSF) (see
ine contractions for labor and delivery; produces Figs. 8–9 and 8–10)
releasing hormones that regulate the secretions of 1. Three meningeal layers made of connective tissue:
the anterior pituitary gland; regulates body tem- outer—dura mater; middle—arachnoid membrane;
perature; regulates food intake; integrates the func- inner—pia mater; all three enclose the brain and
tioning of the autonomic nervous system (ANS); spinal cord.
promotes visceral responses to emotional situa- 2. Subarachnoid space contains CSF, the tissue fluid
tions; acts as a biological clock that regulates body of the CNS.
rhythms. 3. CSF is formed continuously in the ventricles
7. Thalamus—groups sensory impulses as to body of the brain by choroid plexuses, from blood
part before relaying them to the cerebrum; aware- plasma.
ness of pain but inability to localize; suppresses 4. CSF circulates from the ventricles to the central
unimportant sensations to permit concentration; canal of the spinal cord and to the cranial and
contributes to alertness and awareness, and to spinal subarachnoid spaces.
memory. 5. CSF is reabsorbed from the cranial subarachnoid
8. Cerebrum—two hemispheres connected by the space through arachnoid villi into the blood in the
corpus callosum, which permits communication cranial venous sinuses. The rate of reabsorption
between the hemispheres. The cerebral cortex is equals the rate of production.
6. As tissue fluid, CSF brings nutrients to CNS neu- • Preganglionic neurons—from the CNS to the
rons and removes waste products. CSF also acts as ganglia
a shock absorber to cushion the CNS. • Postganglionic neurons—from the ganglia to the
effectors
Cranial Nerves—12 pairs of nerves that • Most sympathetic ganglia are in two chains
emerge from the brain (see Fig. 8–11) just outside the vertebral column; parasympa-
1. Concerned with vision, hearing and equilibrium, thetic ganglia are very near or in the visceral
taste and smell, and many other functions. effectors.
2. See Table 8–4 for the functions of each pair. 4. Neurotransmitters: acetylcholine is released by
all preganglionic neurons and by parasympa-
The Autonomic Nervous System (ANS) (see thetic postganglionic neurons; the inactivator is
Fig. 8–12 and Table 8–5) cholinesterase. Norepinephrine is released by most
1. Has two divisions: sympathetic and parasympa- sympathetic postganglionic neurons; the inactiva-
thetic; their functioning is integrated by the hypo- tor is COMT or MAO.
thalamus. 5. Sympathetic division—dominates during stress sit-
2. Consists of motor neurons to visceral effectors: uations; responses prepare the body to meet physi-
smooth muscle, cardiac muscle, and glands. cal demands.
3. An ANS pathway consists of two neurons that 6. Parasympathetic division—dominates in relaxed
synapse in a ganglion: situations to permit normal functioning.
REVIEW QUESTIONS
1. Name the divisions of the nervous system and state 6. State the names and number of pairs of spinal
the parts of each. (p. 166) nerves. State the part of the body supplied by
the phrenic nerves, radial nerves, and sciatic nerves.
2. State the function of the following parts of nerve (pp. 172, 174)
tissue: (pp. 166–167)
a. Axon 7. Define reflex, and name the five parts of a reflex
b. Dendrites arc. (pp. 172, 174)
c. Myelin sheath
d. Neurolemma 8. Define stretch reflexes, and explain their practical
e. Microglia importance. Define flexor reflexes, and explain
f. Astrocytes their practical importance. (p. 175)
3. Explain the difference between: (pp. 170–171) 9. Name the part of the brain concerned with each of
a. Sensory neurons and motor neurons the following: (pp. 176–179)
b. Interneurons and nerve tracts a. Regulates body temperature
b. Regulates heart rate
4. Describe an electrical nerve impulse in terms of
c. Suppresses unimportant sensations
charges on either side of the neuron membrane.
d. Regulates respiration (two parts)
Describe how a nerve impulse crosses a synapse.
e. Regulates food intake
(pp. 168–169, 171)
f. Regulates coordination of voluntary movement
5. With respect to the spinal cord: (p. 172) g. Regulates secretions of the anterior pituitary
a. Describe its location gland
b. State what gray matter and white matter are h. Regulates coughing and sneezing
made of i. Regulates muscle tone
c. State the function of the dorsal root, ventral j. Regulates visual and auditory reflexes
root, and dorsal root ganglion k. Regulates blood pressure
10. Name the part of the cerebrum concerned with 13. State a function of each of the following cranial
each of the following: (pp. 179–183) nerves: (p. 189)
a. Feels the cutaneous sensations a. Glossopharyngeal
b. Contains the auditory areas b. Olfactory
c. Contains the visual areas c. Trigeminal
d. Connects the cerebral hemispheres d. Facial
e. Regulates accessory movements e. Vagus (three functions)
f. Contains the olfactory areas
g. Initiates voluntary movement
14. Explain how the sympathetic division of the ANS
h. Contains the speech areas (for most people)
helps the body adapt to a stress situation; give
11. Name the three layers of the meninges, beginning three specific examples. (pp. 188–189)
with the outermost. (p. 184)
12. State all the locations of cerebrospinal fluid. What 15. Explain how the parasympathetic division of the
is CSF made from? Into what is CSF reabsorbed? ANS promotes normal body functioning; give
State the functions of CSF. (p. 184) three specific examples. (pp. 189, 191)
FOR FURTHER THOUGHT

1. Your friend Fred was telling a story, with eloquent Now column C: Start at the top and name the col-
gestures, while making a salad. He missed the ors—do not read the words—as fast as you can.
tomato with the knife, cut his hand badly, and Was there any difference? Explain why.
needed quite a few stitches. A local anesthetic was
used. How might a local anesthetic stop nerve A B C
impulses? (Remember that a nerve impulse is very
simple.) What part of Fred’s brain got him into
trouble?
2. Some pesticides kill insects by interfering with
cholinesterase. We have cholinesterase too, and
may be adversely affected. What would be the
symptoms of such pesticide poisoning?
3. We cannot live without a central nervous system.
Describe all the ways in which the central nervous
system is protected.
4. Older drivers are sometimes said to have “lost their
reflexes.” Is this really true? Explain.
5. Look at Question Figure 8–A . Starting at the top
of column A, read the words down as fast as you
can. For column B, start at the top and name the
colors as fast as you can. Did you have any trouble? Question Figure 8–A

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08Scanlon(p3)-ch08 8/17/06 10:48 AM Page 163

Copyright © 2007 by F. A. Davis.

The Nervous System

Copyright © 2007 by F. A. Davis.

Chapter Outline Neurotransmitters

Copyright © 2007 by F. A. Davis.

The Nervous System

Student Objectives (Continued) Parasympathetic (PAR-uh-SIM-puh-THET-ik)

Copyright © 2007 by F. A. Davis.

166 The Nervous System

M ost of us can probably remember being told,

Copyright © 2007 by F. A. Davis.

The Nervous System 167

Afferent (sensory) neuron Efferent (motor) neuron

Myelin sheath Axon

Copyright © 2007 by F. A. Davis.

168 The Nervous System

BOX 8–1 MULTIPLE SCLEROSIS

Copyright © 2007 by F. A. Davis.

The Nervous System 169

Vesicles of neurotransmitter Receptor site

Copyright © 2007 by F. A. Davis.

170 The Nervous System

tion. Sensory neurons from receptors in skin, skeletal

Dorsal root ganglion

Receptor Ventral root Cell body of motor neuron

Copyright © 2007 by F. A. Davis.

The Nervous System 171

THE NERVE IMPULSE

Copyright © 2007 by F. A. Davis.

172 The Nervous System

impulses to the brain. Descending tracts (such as the

Copyright © 2007 by F. A. Davis.

Copyright © 2007 by F. A. Davis.

174 The Nervous System

Table 8–3 MAJOR PERIPHERAL NERVES

Phrenic C3–C5 • Diaphragm

BOX 8–2 SHINGLES

Copyright © 2007 by F. A. Davis.

The Nervous System 175

(2) Sensory neuron Dorsal root ganglion

Femoral nerve Dorsal root

(4) Motor neuron

Copyright © 2007 by F. A. Davis.

176 The Nervous System

BOX 8–3 SPINAL CORD INJURIES

those we think of as vital (as in “vital signs”). The

Copyright © 2007 by F. A. Davis.

Choroid plexus in Midbrain

Copyright © 2007 by F. A. Davis.

178 The Nervous System

Temporal lobe Fourth ventricle

Copyright © 2007 by F. A. Davis.

The Nervous System 179

1. Production of antidiuretic hormone (ADH) and THALAMUS

Copyright © 2007 by F. A. Davis.

180 The Nervous System

In the human brain the cerebral cortex is folded Frontal Lobes

Orbitofrontal Parietal lobe

Motor speech area

Copyright © 2007 by F. A. Davis.

The Nervous System 181

BOX 8–4 CEREBROVASCULAR ACCIDENTS

Copyright © 2007 by F. A. Davis.